Journal of Musculoskeletal Trauma

Comparison of External Fixation and Interlocking IM Nail in Open Tibial Fractures: Hyung Jin Chung, Duck Kyu Kim, Yerl Bo Sung, Jong Guk Ahn; J Korean Soc Fract 2001;14(4):632-642. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.632

Abstract PDF: PURPOSE
To compare and analyze the results of the treatment based on the method of treatment between interlocking IM nail and external fixation of type II, III A, and III B open fractures of the tibia] shaft.
MATERIALS AND METHODS
A clinical analysis was performed on 57 cases of type II, III A, and III B open fractures of tibial shaft from January 1994 to October 1999 those studies are followed at least 1 year or more. The results was analyzed according to complications and functional results based on operative methods of types of open fractures.
RESULTS
In aspect of delayed union and nonunion, interlocking IM nail indicate a great results(p = 0.036) in type II. In angulation, interlocking IM nail marks an outstanding results in case of type II. There is no difference between interlocking IM nail and external fixation in infection. But, the delay of operation after injury increase the possibilities of infection.
CONCLUSION
At present, especially in type m, external fixation was preferred. But, interlocking IM nail has a good results in aspect of complications. Therefore unreamed intramedullary nailing for open tibia shaft fractures is a good treatment method to be recommended.

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The Results and Complications After Treatment of Open Tibia Fractures in Children: Chung Nam Kang, Jong Ho Kim, Dong Wook Kim, Young Do Gho, Jae Doo You, Jin Chang; J Korean Soc Fract 1998;11(2):464-470. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.464

We describe the results of treatment and complication of open tibial fractures in 44 children. There were 30 males and 14 females with an average age of the 6.7 years(range 3~2 years). The mean follow up period was 15 months(range 1.4~28month). According to the classification of Gustilo et al, Type I were 17 cases, Type II were 13 cases, Type IIIA were 9 cases and Type IIIB were 5 cases. All patient received tetanus prophylaxis, and systemic thirty-four with minimal soft tissue injury were closed primarily. The other 10 were initially left open; of these, 7 wounds were allowed to heal secondarily and 3 larger wounds required split skin grafts. The average time to healing of the fracture was 12.9weeks(range 6.9~22.4weeks). The complication included superficial infection(7%), malunion(5%), delayed union(2%), synostosis(2%), and leg length discrepancy(5%): these incidences are similar to those reported in adult. The osteomyelitis, compartment syndrome, and vascular injury didn't developed at any case. The K-wire fixation of open tibia fractures of the childrens is very useful to prevent the displacement and to care for the openwound without the risk of deep infection.

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Analysis of Treatment Outcomes for Open Fractures of the Tibia in Children
Jong-Hyuk Park, Jung Ryul Kim, Dong Hun Ham, Hyung Suk Lee, Sung Jin Shin
Journal of the Korean Orthopaedic Association.2010; 45(6): 440. CrossRef

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The Treatment of Type III Open Tibia Fractures with Ender Nails: Preliminary Report: Sang Ho Ha, Sang Hong Lee, Dong Min Shin, Jin Seok Park; J Korean Soc Fract 1989;2(2):219-228. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.219

Abstract PDF: Type III open tibial fracture is difficult to treat beacause of frequent complications, and recently external fixation have been used successfully. Intramedullary nailing with flexible nails is now routinely performed in Type I and II open tibial fractures. Thirteen cases of Type III open tibial fractures teated with Ender nails from January 1 983 to December 1988 were identified and retrospectively reviewed. The results were as follows; 1. The patients were predominantly more common in male and the average age was 41 years, and most common cause was traffic accident. 2. According to the Gustilo and Andersons classification, Type III-A was 7 cases, TypeIII-B was 5 cases, and Type III-C was 1 case. All 13 cases were combined fibular fracture. 3. All 13 cases were used two Ender nails, nailing methods were two antegrade insertioni (7 cases), two retrograde insertion (3 cases), and one antegrade & retrograde insertion (3 cases). 8 cases were operated within one day of accident, 7 cases were used other combined metals, and 5 cases were treated with Rush pinning of fibular fracture. 4. Among the secondary additional operation required after Ender nailing, bone operation were 7 cases, soft tissue operation were 5 cases, and delayed amputation were 2 cases. 5. Among II cases except amputation, controversial complications were nonunion (6 cases), chronic osteomyelitis (1 case), delayed union (1 case). 6. A retrospective evaluation of 13 cases treated Ender nailing revealed that Ender nailing was simple, effective method in some selected cases of Type III open tibia fractures.

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